No, we shouldn't worry too much about getting COVID from young kids

Very high vaccination rates in Australia are ensuring community COVID transmission is decreasing^[1].

Vaccines markedly reduce severe disease and death. Our health-care systems are more able to cope because fewer new cases are requiring admission to hospital and ICU.

But, children under 12 years of age aren’t yet eligible for vaccination and some people are asking whether children are going to become a reservoir of infection.

Are children now a major risk for COVID transmission? Should we worry about exposure to COVID in places that kids and their families frequent, such as schools, pools, cinemas, and sporting and recreational facilities?

The short answer to those questions is – no. Evidence suggests kids aren’t major drivers of COVID spread, so it’s only fair to let kids get back to their normal activities.

Aren’t kids the main ones getting COVID?

Children are gradually making up a higher proportion of COVID infections^[2]. This was expected as older age groups are vaccinated^[3] and their rates of infection have declined.

But overall, infection numbers in kids haven’t increased^[4]. In fact, the number of infections in children in NSW remained roughly the same^[5] after lockdown ended as it was in the weeks before.

This confirms what was known from evidence overseas – young children are not major drivers^[6] of COVID, especially with the mitigation measures currently in place in schools.

Read more: Why do kids tend to have milder COVID? This new study gives us a clue^[7]

It depends on where you’re exposed

The risk of children transmitting the coronavirus is different in different settings.

In the home, we know the Delta strain is easily transmitted^[8] among household members, regardless of whether a child or adult is the first infected case^[9].

Yet at school, the risk of catching COVID is much lower, even with the Delta variant^[10].

This low risk likely also holds true in outdoor public spaces, such as sports grounds, parks and swimming pools.

Can I still catch COVID from an unvaccinated child even if I’m vaccinated?

Recently vaccinated adults have a 70-90% lower chance of getting COVID^[11], irrespective of the vaccine they’ve received, according to a recent pre-print of a study yet to be peer reviewed. Vaccinated adults are also 30-60% less likely to transmit^[12] the virus onwards.

COVID vaccines are even more effective (greater than 90%) at keeping adults and young people out of hospital and potentially dying.

Being a vaccinated adult reduces the risk of severe disease and hospitalisation tenfold^[13], compared to unvaccinated adults.

What’s more, children are less likely to transmit to others than adults^[14].

Reassuringly, despite the reopening of schools and the restarting of childhood activities, hospitalisation and ICU admission rates have gone down in NSW^[15].

This indicates vaccines are successfully preventing moderate and severe COVID in adults.

This data is with the Delta variant, and we don’t yet know whether the new Omicron variant will be any different.

Read more: Your unvaccinated friend is roughly 20 times more likely to give you COVID^[16]

Why haven’t we vaccinated kids yet? Wouldn’t that help stop any risk of transmission?

While the vaccines developed for COVID are safe^[17], we know children are not simply little adults.

Vaccine programs typically evolve over time. Experts initially monitor for side effects following widespread vaccination in adults before a vaccine is administered to younger age groups^[18].

Children’s immune responses differ^[19] to those in adults. It takes time to ensure the right dose and timing between vaccinations has been considered carefully in kids.

Given the very low risk of severe COVID in children^[20], weighing up the benefits of COVID vaccination for them is complex.

That’s why the experts from Australia’s Technical Advisory Group on Immunisation (ATAGI) are being careful and considered in their advice regarding vaccination in young children^[21].

It’s safe and beneficial for kids and families to get out and about

The pandemic has impacted children’s lives significantly^[22].

School closures and lockdowns have affected their education and social interaction with friends. Community sport and other activities that give children a strong sense of belonging^[23] and enhance self-esteem have been cancelled.

All this has impacted the mental health of children and young people^[24].

Read more: Do kids get long COVID? And how often? A paediatrician looks at the data^[25]

Vaccines work and measures such as COVID-safe guidelines, QR-code check-ins, physical distancing and masks are still in place in many settings. Enhanced hygiene is still encouraged.

Vaccinated adults should feel comfortable to move about and socialise.

Children have sacrificed their personal well-being largely to protect adults from COVID. We now have high levels of adult vaccination and stable or reducing community transmission.

Children need to be given the opportunity to return to public spaces, play sport, and engage in other recreational and social activities.

It’s time children and families are given the opportunity to resume normal activities to ensure their health and well-being.

References

1. ^{^} community COVID transmission is decreasing (www.health.gov.au)
2. ^{^} higher proportion of COVID infections (www.health.nsw.gov.au)
3. ^{^} older age groups are vaccinated (www.health.gov.au)
4. ^{^} haven’t increased (www.health.nsw.gov.au)
5. ^{^} roughly the same (www.health.nsw.gov.au)
6. ^{^} young children are not major drivers (www.nature.com)
7. ^{^} Why do kids tend to have milder COVID? This new study gives us a clue (theconversation.com)
8. ^{^} easily transmitted (jamanetwork.com)
9. ^{^} a child or adult is the first infected case (www.ncirs.org.au)
10. ^{^} even with the Delta variant (www.ncirs.org.au)
11. ^{^} 70-90% lower chance of getting COVID (www.medrxiv.org)
12. ^{^} 30-60% less likely to transmit (www.nejm.org)
13. ^{^} reduces the risk of severe disease and hospitalisation tenfold (www.health.nsw.gov.au)
14. ^{^} less likely to transmit to others than adults (www.nature.com)
15. ^{^} have gone down in NSW (www.health.nsw.gov.au)
16. ^{^} Your unvaccinated friend is roughly 20 times more likely to give you COVID (theconversation.com)
17. ^{^} are safe (www.health.gov.au)
18. ^{^} before a vaccine is administered to younger age groups (theconversation.com)
19. ^{^} Children’s immune responses differ (www.scientificamerican.com)
20. ^{^} very low risk of severe COVID in children (www.medrxiv.org)
21. ^{^} careful and considered in their advice regarding vaccination in young children (www.smh.com.au)
22. ^{^} impacted children’s lives significantly (jamanetwork.com)
23. ^{^} children a strong sense of belonging (ijbnpa.biomedcentral.com)
24. ^{^} impacted the mental health of children and young people (jamanetwork.com)
25. ^{^} Do kids get long COVID? And how often? A paediatrician looks at the data (theconversation.com)